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Query: UMLS:C0039483 (giant cell arteritis)
 3,204 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We have evaluated 100 biopsies of temporal artery carried out in the Hospital La Paz from 1972 to 1986. On the basis of the histological result and the final diagnosis we divided the patients in five groups: I, temporal arteritis/polymyalgia rheumatica with positive biopsy, 11 cases; II, temporal arteritis without polymyalgia symptoms and with positive biopsy, 16 cases; III, temporal arteritis with negative biopsy, 7 cases; IV, polymyalgia with negative biopsy, 14 cases; and V, other diagnoses, 43 cases. The number of diagnoses of temporal arteritis/polymyalgia rheumatica has increased throughout the recent years, although the positive biopsies/overall biopsies ratio has remained constant. Certain symptoms such as claudication, headache, amaurosis and Raynaud's phenomenon have a high predictive value of a positive result, but their sensitivity is low. In the 25 patients with polymyalgia, biopsy was positive in 11, out of which 4 did not have features of temporal arteritis. Biopsy was positive in 4 out of the 9 patients in whom it was repeated in the contralateral side. The diagnostic yield was higher in those cases in whom it was indicated for classical temporal arteritis symptoms, but we emphasize that there was a 19% positive rate in patients who presented with fever of unknown origin, while it was only 5.5% in those in whom a constitutional syndrome was being evaluated. We conclude that the use of temporal biopsy should be more widespread, as its cost is low and it has no side effects; therefore, it can achieve a great benefit for the patient with a shorter and less expensive hospital stay.
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PMID:[Usefulness of temporal artery biopsy: analysis of 100 cases]. 270

A 63-year-old woman with psoriatic arthritis developed arthralgias and shoulder girdle myalgias which were controlled with amitriptyline. Some months later she presented with headache, jaw claudication, weight loss, and chest pain. Anemia of chronic disease, cholestasis, steatorrhea, and pericardial effusion were noted. Giant cell arteritis (GCA) was diagnosed on temporal artery biopsy and prednisone was begun. Her symptoms rapidly abated but steatorrhea continued. It is suggested that these problems were related to GCA. Physicians need to be alert to the diverse presentations of GCA.
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PMID:Giant cell arteritis associated with pericarditis and pancreatic insufficiency in a patient with psoriatic arthritis. 271 1

Very few cases of pulmonary vasculitis that cannot be classified into a single category of vasculitis have been described. We report the first case of a vasculitic process in which pulmonary involvement with asthma, eosinophilic interstitial infiltrates, and small nodules were seen in association with jaw claudication and temporal arteritis with giant cells found on biopsy. Other signs of systemic involvement were also present such as peripheral neuropathy, hematuria with erythrocytic casts and proteinuria, pericardial effusion, and a dilated cardiomyopathy. The histopathologic picture was complex and unique. The early age of onset, the multisystemic involvement, and the prompt response to cyclophosphamide pointed to a diagnosis of "polyangiitis overlap syndrome," with some aspects of Churg-Strauss syndrome and also temporal arteritis. Physicians should be aware of these polymorphous and life-threatening pulmonary vasculitic syndromes, which require aggressive immunosuppressor therapy.
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PMID:Concurrent Churg-Strauss syndrome and temporal arteritis in a young patient with pulmonary nodules. 272 57

Three patients (one with polymyalgia rheumatica with jaw claudication and two with biopsy-proven giant cell arteritis) were initially treated using prednisone (40-60 mg daily). The response was good in all three, but each experienced exacerbation of symptoms and elevation of Westergren sedimentation rates (WSR) with dose reduction. The addition of methotrexate (7.5-12.5 mg/wk) resulted in diminished symptoms and lower WSR and proved to be steroid-sparing.
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PMID:Methotrexate for corticosteroid-resistant polymyalgia rheumatica and giant cell arteritis. 274 46

Thirty-two patients (26 female, 6 male) with angiographically diagnosed Takayasu arteritis were seen at the Mayo Clinic between 1971 and 1982. Racial composition of this group was 23 North American Caucasians, 4 Mexicans, 3 Orientals, 1 Native American, and 1 patient of Middle Eastern origin. Incidence of the disease in Olmsted County, Minnesota, was 2.6/million/year. Diagnosis was often delayed for long periods of time, with a median delay of 18 months. Patients had both non-vascular symptoms (arthralgias in 56%, fever in 44%, weight loss in 38%) and symptoms of vascular stenosis such as arm claudication (47%) and hypertension due to renal artery stenosis (41%). All patients had either multiple vascular bruits (94%) or absent pulses (50%). Laboratory findings included anemia (44%) and elevations of erythrocyte sedimentation rate (78%). Almost all patients had multiple sites of arterial involvement documented by angiogram with various combinations of stenosis, luminal irregularity and aneurysm formation. Response to corticosteroid treatment was usually very good, with dramatic improvement in non-vascular symptoms and return of pulses in 8 of the 16 patients with absent pulses prior to treatment. Five-year survival rate from time of diagnosis was 94%. Twelve patients underwent surgical procedures involving the carotid arteries (5 cases), subclavian artery (4 cases) and renal arteries (3 cases). Three aneurysms were resected, one had aortic valve replacement for severe aortic regurgitation, and two patients underwent transluminal angioplasty. Pathologic changes were restricted to the media and adventitial layers of the vessel wall and were indistinguishable from those of giant-cell or temporal arteritis. Takayasu arteritis is more common than previously suspected in North America, is not restricted to any one racial group, and is readily treatable with corticosteroids and surgical vascular reconstruction.
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PMID:Takayasu arteritis. A study of 32 North American patients. 285 47

Ten patients aged from 60 to 73 years presenting with Horton's disease or polymyalgia rheumatica had arteritis of the upper limbs. Asymptomatic abolition of pulse in the upper limbs (1 case) or claudication at rest or exercise (9 cases) and/or Raynaud's phenomenon (5 cases) preceded (4 cases) or accompanied (1 case) the discovery of giant cell arteritis, or complicated the reduction or discontinuation of corticosteroid therapy. Diagnosis rested on the regular association of an inflammatory syndrome with multiple arterial tapered stenoses and/or arterial thrombosis in the post-vertebral subclavian, axillary or brachial arteries and, chiefly, on the demonstration (in 7 cases) of a giant cell granuloma at biopsy of the temporal artery. Corticosteroid therapy (1 mg/kg/24 h in 8 cases and 0.5 mg/kg/24 h in 2 cases) initially combined with anticoagulants in 4 cases resulted in rapid regression of ischaemic and systemic signs in all patients, thus avoiding surgical revascularization of the upper limbs.
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PMID:[Subclavian and axillary arteritis in Horton's disease and rhizomelic pseudopolyarthritis. 10 cases]. 313 26

Giant cell arteritis is a visually devastating disease that primarily affects the over 55 age group. This granulomatous inflammation affects large and medium-sized arteries anywhere in the body. Systemic manifestations of this disease include: jaw claudication, scalp tenderness, malaise and vertigo. Decreased appetite and/or anorexia may also be seen. Ocular manifestations may include ischemic optic neuropathy with sudden markedly reduced visual acuity. Steroid treatment is used to protect the uninvolved eye. In its classic form the disease is monitored by adjusting the steroid dosage with the erythrocyte sed rate (ESR). Prognosis for visual restoration in the involved eye is poor.
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PMID:Giant cell arteritis. 323 Feb 40

From 1982 through 1987, 107 patients underwent temporal artery biopsy at the Lahey Clinic. In 29 patients, biopsy revealed temporal arteritis (TA). These patients had appreciably more jaw claudication, anemia, anorexia and a higher erythrocyte sedimentation rate (ESR) than patients whose temporal artery biopsy revealed negative findings. Certain clinical criteria and symptom clusters, which include jaw claudication, are highly specific for positive results on temporal artery biopsy. Length of arterial segment examined and previous corticosteroid therapy did not influence the results of temporal artery biopsy. TA should be confirmed histologically whenever possible. When results of biopsy are negative, patients fulfilling clinical criteria or having symptom clusters specific for TA should receive steroid treatment.
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PMID:Temporal arteritis: clinical aids to diagnosis. 323 May 66

Jaw claudication (angina masticatorica) is one of the best known signs of giant cell arteritis (Horton's arteritis). Other symptoms are pain, swelling, redness and necrosis of the face, mouth, and nasal mucosa (ulcerous pharyngitis, glossitis) leading to disturbances in swallowing. In rare cases there are alterations of smelling and hearing. The knowledge of such non-characteristic symptoms can be of diagnostic importance in cases of Horton's arteritis without local signs in the temporal area, visual failure or polymalgia rheumatica.
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PMID:[Symptoms and findings of giant cell arteritis in the area of the ear, nose, and throat]. 332 Jun 47

An elevated erythrocyte sedimentation rate is regarded as a hallmark of temporal arteritis. Thirty-five cases of biopsy-proved temporal arteritis without an elevated erythrocyte sedimentation rate are identified, and a 36th case is described. All patients had age-adjusted normal Westergren sedimentation rates, 16 with sedimentation rates of 20 mm per hour or less and 20 with sedimentation rates of 21 to 40 mm per hour. Twenty-two patients had sufficient clinical information for analysis and comparison with reported series of patients with biopsy-proved temporal arteritis with an elevated Westergren sedimentation rate. Headache (41 percent), temporal artery abnormalities (41 percent), and visual symptoms (36 percent) were the most common manifestations in patients without an elevated sedimentation rate. Headache (41 percent versus 75 percent, p less than 0.05) and jaw claudication (9 percent versus 43 percent, p less than 0.025) were found less often in the patients without an elevated sedimentation rate. History and physical examination are essential in the diagnosis of temporal arteritis with a normal Westergren sedimentation rate.
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PMID:Temporal arteritis without an elevated erythrocyte sedimentation rate. Case report and review of the literature. 351 41


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